STENT DELIVERY SYSTEM
An example stent delivery system is disclosed. The example stent delivery system includes an outer shaft having a distal end region, an inner surface and a lumen extending therein. The delivery system also includes an inner shaft extending within the outer shaft lumen, the inner shaft having a stent receiving region disposed along a distal end region thereof. Additionally, the delivery system includes a stent disposed along the stent receiving region and a braided member positioned radially outward from an outer surface of the stent and radially inward from the inner surface of the outer shaft, the braided member being attached to an outer surface of the inner member proximal of the stent. Additionally, the delivery system includes a plurality of tether members coupled to the braided member, wherein longitudinal retraction of the outer shaft relative to the inner shaft exposes the stent from the braided member.
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This application is a continuation of U.S. Application No. 16/789,833, filed Feb. 13, 2020, which claims the benefit of priority of U.S. Provisional Application No. 62/806,580 filed Feb. 15, 2019, the entire disclosures of which are hereby incorporated by reference.
TECHNICAL FIELDThe present disclosure pertains to medical devices and methods for making and using medical devices. More particularly, the present disclosure pertains to stent delivery systems.
BACKGROUNDA wide variety of intracorporeal medical devices have been developed for medical use, for example, intravascular use. Some of these devices include stent delivery systems. In some instances, an implantable medical device (e.g., self-expanding stents) may be used for treatment of the esophagus, a stenosis in a blood vessel, used to maintain a fluid opening or pathway in the vascular, urinary, biliary, tracheobronchial, esophageal, or renal tracts, or position a device such as an artificial valve or filter within a body lumen, for example.
Stents are generally tubular shaped devices which function to expand within a segment of a body lumen, such as an esophagus, a trachea, a colon, a blood vessel, or other body lumen or cavity. Stents are usually delivered in a compressed condition to a target site and then deployed at that location into an expanded condition to support the body lumen. During delivery, self-expanding stents are generally compressed, or otherwise radially constrained, to a reduced diameter that is smaller than its diameter when deployed at the target site. When positioned at the desired target site within the body lumen, the stent may be deployed by removing the constraining force, which allows the stent to self-expand to a diameter sufficient to treat the target tissue site.
In some instances, the constraining force placed upon the self-expanding stent may be imparted by an outer sheath or deployment tube. Retraction of the outer deployment tube relative to the self-expanding stent may release the stent from a compressed configuration to an expanded (e.g., deployed) configuration. However, in some instances, the inner surface of the deployment tube may impart undesirable frictional forces on the outer surface of the stent. These frictional forces may result in difficulty loading the stent into the deployment system and/or deploying the stent from the deployment system. Accordingly, it may be desirable to provide stent delivery systems designed to reduce the frictional forces between the outer deployment tube and the self-expanding stent.
BRIEF SUMMARYThis disclosure provides design, material, manufacturing methods, and use alternatives for medical devices. An example stent delivery system includes an outer shaft having a distal end region and an inner surface defining a lumen extending therein. The delivery system also includes an inner shaft extending at least partially within the lumen of the outer shaft, the inner shaft having a stent receiving region disposed along a distal end region thereof. Additionally, the delivery system includes a stent disposed along the stent receiving region, the stent having an outer surface. Further, the delivery system includes a braided member positioned radially outward from the outer surface of the stent and radially inward from the inner surface of the outer shaft, the braided member being attached to an outer surface of the inner member proximal of the stent. Additionally, the delivery system includes a plurality of tether members coupled to the braided member and extending therefrom, wherein longitudinal retraction of the outer shaft relative to the inner shaft exposes the stent from the braided member.
Alternatively or additionally to any of the embodiments above, wherein each of the plurality of tether members includes a first end directly attached to the braided member and a second end directly attached to the outer shaft.
Alternatively or additionally to any of the embodiments above, wherein the braided member includes a proximal end and a distal end, and wherein the proximal end of the braided member is attached to the outer surface of the inner member, and wherein the distal end is attached to the first end of each of the plurality of tether members.
Alternatively or additionally to any of the embodiments above, wherein the braided member is configured to space the inner surface of the outer shaft radially away from the outer surface of the stent.
Alternatively or additionally to any of the embodiments above, wherein the braided member exerts a radially compressive force along the stent.
Alternatively or additionally to any of the embodiments above, wherein retracting the outer shaft slides the inner surface of the outer shaft along an outer surface of the braided member.
Alternatively or additionally to any of the embodiments above, wherein the braided member includes a proximal end region, and wherein the proximal end region includes a tapered portion tapering to a smaller diameter in a proximal direction.
Alternatively or additionally to any of the embodiments above, wherein the braided member includes a longitudinal axis and a length measured along the longitudinal axis from a proximal end of the braided member to a distal end of the braided member, and wherein the braided member is configured to axially compress along the longitudinal axis as the outer member is retracted in a proximal direction such that the length of the braided member is reduced.
Alternatively or additionally to any of the embodiments above, wherein retraction of the outer shaft uncovers at least a portion of the braided member, and wherein the uncovered portion of the braided member expands radially outward as the outer member is retracted.
Alternatively or additionally to any of the embodiments above, wherein retraction of the outer shaft retracts the plurality of tether members in a proximal direction, and wherein retraction of the tether members folds the braided member back on itself.
Alternatively or additionally to any of the embodiments above, wherein the braided member includes a longitudinal axis, and wherein retraction of the outer shaft retracts the plurality of tether members, and wherein retraction of the plurality of tether members axially compresses the braided member along the longitudinal axis.
Alternatively or additionally to any of the embodiments above, wherein each of the plurality of tether members includes a first end attached to an outer surface of the inner shaft and a second end attached to a distal end of the braided member.
Alternatively or additionally to any of the embodiments above, wherein the outer shaft includes a plurality of apertures extending through a wall thickness of the outer member, and wherein each of the plurality of tether members passes through one of the plurality of apertures extending through the wall thickness of the outer member.
Alternatively or additionally to any of the embodiments above, wherein retraction of the outer shaft draws a portion of each of the plurality of tether members into the lumen of the outer shaft.
Another example stent delivery system includes an outer shaft having a distal end region, an inner surface and a lumen extending therein. The delivery system also includes an inner shaft extending at least partially within the lumen of the outer shaft, the inner shaft having a stent receiving region disposed along a distal end region thereof, wherein the inner shaft is designed to translate longitudinally relative to the outer shaft. Additionally, the delivery system includes a stent disposed along the stent receiving region, the stent having an outer surface, wherein the stent is configured to shift from a first radially collapsed configuration when subjected to a radially constraining force to a radially expanded configuration when free of the radially constraining force. The delivery system also includes a braided sleeve positioned between the outer surface of the stent and the inner surface of the outer shaft, the braided sleeve configured to radially compress the stent in the first configuration. Additionally, the delivery system includes one or more tether members coupled to the braided sleeve and extending therefrom, wherein longitudinal retraction of the outer shaft relative to the inner shaft exposes the stent from the braided member.
Alternatively or additionally to any of the embodiments above, wherein the braided member is configured to space the inner surface of the outer shaft radially away from the outer surface of the stent.
Alternatively or additionally to any of the embodiments above, wherein retracting the outer shaft slides the inner surface of the outer shaft along an outer surface of the braided sleeve.
Alternatively or additionally to any of the embodiments above, wherein each of the one or more tether members includes a first end directly attached to a distal end of the braided sleeve and a second end directly attached to the outer shaft.
Alternatively or additionally to any of the embodiments above, wherein each of the one or more tether members includes a first end attached to the inner member at a location proximal of the stent and a second end attached to a distal end of the braided sleeve.
An examples method of treating a body lumen includes advancing a stent delivery system to a target tissue site, wherein the stent delivery system includes an outer shaft having a distal end region and an inner surface defining a lumen extending therein, an inner shaft extending at least partially within the lumen of the outer shaft, the inner shaft having a stent receiving region disposed along a distal end region thereof, a stent disposed along the stent receiving region, the stent having an outer surface, a braided sleeve positioned radially outward from the outer surface of the stent and radially inward from the inner surface of the outer shaft, the braided sleeve being attached to an outer surface of the inner member proximal of the stent, and one or more tether members, a first end of each of the one or more tether members being coupled to a distal end of the braided sleeve and extending therefrom. The method further includes retracting the outer shaft relative to the inner shaft to apply a tension force to the one or more tether members to proximally retract the distal end of the braided sleeve to expose the stent from the braided sleeve and permit the stent to radially expand.
The above summary of some embodiments is not intended to describe each disclosed embodiment or every implementation of the present disclosure. The Figures, and Detailed Description, which follow, more particularly exemplify these embodiments.
The disclosure may be more completely understood in consideration of the following detailed description of various embodiments of the disclosure in connection with the accompanying drawings, in which:
While the disclosure is amenable to various modifications and alternative forms, specifics thereof have been shown by way of example in the drawings and will be described in detail. It should be understood, however, that the intention is not to limit the disclosure to the particular embodiments described. On the contrary, the intention is to cover all modifications, equivalents, and alternatives falling within the spirit and scope of the disclosure.
DETAILED DESCRIPTIONFor the following defined terms, these definitions shall be applied, unless a different definition is given in the claims or elsewhere in this specification.
All numeric values are herein assumed to be modified by the term “about,” whether or not explicitly indicated. The term “about” generally refers to a range of numbers that one of skill in the art would consider equivalent to the recited value (i.e., having the same function or result). In many instances, the terms “about” may include numbers that are rounded to the nearest significant figure.
The recitation of numerical ranges by endpoints includes all numbers within that range (e.g. 1 to 5 includes 1, 1.5, 2, 2.75, 3, 3.80, 4, and 5).
As used in this specification and the appended claims, the singular forms “a”, “an”, and “the” include plural referents unless the content clearly dictates otherwise. As used in this specification and the appended claims, the term “or” is generally employed in its sense including “and/or” unless the content clearly dictates otherwise.
The following detailed description should be read with reference to the drawings in which similar elements in different drawings are numbered the same. The drawings, which are not necessarily to scale, depict illustrative embodiments and are not intended to limit the scope of the disclosure.
As stated above, during delivery, self-expanding stents are generally compressed, or otherwise radially constrained, to a reduced diameter that is smaller than its diameter when deployed at the target site. When positioned at the desired target site within the body lumen, the stent may be deployed by removing the constraining force, which allows the stent to self-expand to a diameter sufficient to treat the target tissue site.
Further, as discussed above, in some examples the radially constraining force placed upon the self-expanding stent may be imparted by an outer deployment sheath. Retraction of the outer deployment sheath relative to the self-expanding stent may release the stent from a compressed (e.g., loaded) configuration to a radially expanded (e.g., deployed) configuration. However, in some instances, the inner surface of the deployment tube may impart undesirable frictional forces on the outer surface of the stent. These frictional forces may result in difficulty loading the stent into the deployment system and/or deploying the stent from the deployment system. Examples disclosed herein provide stent delivery systems designed to reduce the frictional forces between the outer deployment tube and the self-expanding stent.
The example stent delivery system 10 illustrated in
The inner tubular member 18 may include a proximal end which is coupled to a handle 22 and a distal end which includes or is coupled to a tip 26. The tip 26 may be attached to, incorporated with, or otherwise disposed at the distal end of inner member 18. The tip 26 may generally have a tapered, rounded or smooth shape that provides a generally atraumatic distal end to system 10. For example, the tip 26 may have a smooth distal portion that gently tapers in a proximal-to-distal direction. In some examples a portion of the inner member 18 may extend into a portion of the tip 26 and be secured thereto. However, in other examples it is contemplated that the tip 26 and the inner member 18 may be formed as a monolithic structure. Additionally, while not shown in
The inner member 18 may include a stent receiving region about which a stent 28 may be disposed. The length and/or configuration of the stent receiving region may vary. For example, the stent receiving region may have a length sufficient for the stent 28 to be disposed thereon in a radially compressed, constrained configuration within outer sheath 16. In other words, the stent 28 may surround the stent receiving region of the inner member 18 with the stent 28 positioned in a compressed (e.g., loaded) configuration between the inner surface of the outer sheath 16 (e.g., the inner surface which defines the lumen of the outer sheath 16) and the outer surface of the inner member 18. In other words, the distal end region 24 of the outer sheath 16 may compress the stent 28 radially inward along the outer surface of the inner member 18. It can be appreciated that the length of the stent 28 utilized for system 10 may dictate the desired length of the stent receiving region to accommodate stent 28.
However,
As will be discussed in greater detail below, the friction-reducing member 30 may include a proximal end which is secured to the inner member 18 proximal of the proximal end of the stent 28. For example, the proximal end of the friction-reducing member 30 may be affixed to the outer surface of the inner member 18 at a location proximal of the stent receiving region, and thus proximal of the stent 28. The friction-reducing member 30 may extend over the entire length of the constrained stent 28, with a distal end of the friction-reducing member 30 located distal of the distal end of the stent 28 in the radially contracted configuration when loaded within the outer sheath 16. The proximal end of the friction-reducing member 30 may be the only portion of the friction-reducing member 30 directly secured to the inner member 18, with the remainder of the length of the friction-reducing member 30 surrounding, but spaced away from the inner member 18.
Additionally, the friction-reducing member 30 may include a distal end coupled to one or more, or a plurality of tether members 32. The tether members 32 may have a first end which is coupled to (e.g., tied to) the distal end of the inner tubular member 18 (as discussed). In some instances, a second end (opposite the first end) of the tether members 32 are coupled to the outer sheath 16 or otherwise engaged with the outer sheath 16. In other instances, the second end of the tether members 32 may be coupled to the inner member 18 at a location proximal of the stent 28. Further discussion of the friction-reducing member 30 is presented below.
Deployment of the stent 28 at a target tissue site may include retracting the outer sheath 16 relative to the inner member 18 to uncover the stent 28 from the outer sheath 16 (which is disposed over the stent 28 during delivery). For example, the outer sheath 16, which may overlie the stent 28, may be proximally retracted (relative to the stent 28) in a distal-to-proximal direction such that the stent 28 is uncovered. In other instances, distal advancement of the outer sheath 16 (relative to the stent 28) may cover the stent 28 when being positioned in a loaded configuration within the stent delivery system 10. Longitudinal actuation (proximal retraction and/or distal advancement) of the outer sheath 16 may include actuation (e.g., proximal retraction and/or distal advancement) of a handle member 20 coupled to the proximal end of the outer sheath 16 relative to a handle member 22 coupled to the proximal end of the inner member 18.
The radially expandable first end region 34 and/or the second end region 36 of the stent 28 in at least some examples disclosed herein may be constructed from a variety of materials. For example, the expandable first end region 34 and/or the second end region 36 of the stent 28 may be constructed from a metal (e.g., Nitinol). In other instances, the expandable first end region 34 and/or the second end region 36 of the stent 28 may be constructed from a polymeric material (e.g., PET). In yet other instances, the expandable first end region 34 and/or the second end region 36 of the stent 28 may be constructed from a combination of metallic and polymeric materials. Additionally, the expandable first end region 34 and/or the second end region 36 of the stent 28 or portions thereof may include a bioabsorbable and/or biodegradable material.
In some instances, the example stent 28 may include one or more layers (e.g., covering, coating, etc.) of material positioned on and/or adjacent to the outer surface of the stent 28. For example, the first end region 34 and/or the second end region 36 of the stent 28 may include a covering of material positioned on and/or adjacent to the strut members 38. In some instances, the outer layer or covering may be an elastomeric or non-elastomeric material. For example, the outer layer or covering may be a polymeric material, such as silicone, polyurethane, or the like. Further, the outer layer may span the spaces (e.g., openings, cells, interstices) between strut members 38 of the first end region 34 and/or the second end region 36 of the stent 28.
In some examples, the medial region 40 stent 28 may include a flexible polymeric portion which has no underlying stent support. For example, the medial region 40 may include a tubular polymeric portion having an inner surface and an outer surface. The medial region 40 may include a first end which is coupled to the first end region 34 of the stent 28 and a second end which is coupled to the second end region 36 of the stent 28. Thus, the medial region 40 may consist only of the polymeric covering spanning between the first end region 34 and the second end region 36 of the stent 28.
In some examples, the friction-reducing member 30 shown in
As shown in
The tether members 32 may include a variety of materials. For example, the tether members 32 may be formed from an inelastic or elastic material. In some instances, the tether members 32 may include a suture, a thread, a wire or any other similar structure.
Additionally, the friction-reducing member 30 (including filaments 44) may be constructed from a variety of materials. For example, the friction-reducing member 30 (including filaments 44) may be constructed from a metal (e.g., Nitinol). In other instances, the friction-reducing member 30 (including filaments 44) may be constructed from a polymeric material (e.g., PET, PTFE, PEEK, etc.). In yet other instances, the friction-reducing member 30 (including filaments 44) may be constructed from a combination of metallic and polymeric materials. Additionally, the friction-reducing member 30 (including filaments 44) or portions thereof may include a bioabsorbable and/or biodegradable material. In some instances, filaments 44 of the friction-reducing member 30 may be coated with polytetrafluoroethylene (PTFE) or other low friction material.
As will be further illustrated, in some instances it may be desirable to design the friction-reducing member 30 to change shape and/or manipulate the shape of the friction-reducing member 30 during deployment of the stent 28. For example, as the stent delivery system 10 is manipulated to deploy the stent 28, the friction-reducing member 30 may extend out of the distal end of the outer sheath 16 and eventually fold back on itself. In other words, as the outer sheath 16 is retracted (relative to the stent 28 as described above) to uncover and deploy the stent 28, a portion (or all of) the friction-reducing member 30 may also be uncovered. Further, because the distal end of the friction-reducing member 30 is coupled to the tether members 32, as the outer sheath 16 is retracted the friction reducing member 30 a tensile force applied to the tether members 32 may cause the distal end of the friction-reducing member 30 to be retracted proximally toward the proximal end of the friction reducing member 30.
As can be seen from
As discussed above, the stent 28 may be disposed about (i.e., surround) the inner member 18 (e.g., surround the stent receiving region of inner member 18). In some embodiments, the stent 28 may be a self-expanding stent, with the stent 28 held in a radially constrained configuration during delivery to a deployment location of a patient. Accordingly, the stent 28 may be biased to outwardly expand when unconstrained and deployed from the stent delivery system 10. For example, the stent 28 may be loaded onto the inner member 18 by radially compressing the stent 28 around the inner member 18. The stent 28 may then be restrained within the outer sheath 16 in the radially compressed configuration as the outer sheath 16 surrounds the stent 28 in the radially compressed configuration. In alternative embodiments, however, the stent 28 may be directly loaded onto the inner member 18 via crimping or any other suitable mechanical holding mechanism.
As discussed above,
It can be appreciated that the friction-reducing member 30 may be designed to reduce the frictional forces generated along the inner surface of the outer sheath 16 as the outer sheath 16 is proximally retracted (to deploy the stent 28, as discussed above) as the frictional forces are generated between the inner surface of the outer sheath 16 and the friction-reducing member 30, instead of between the inner surface of the outer sheath 16 and the stent 28. It can further be appreciated that the braided configuration of the friction-reducing member 30 may reduce and/or limit the degree to which the inner surface of the outer sheath 16 contacts the friction-reducing member 30. Further, the specific material utilized to form the friction-reducing member 30 may help reduce the friction forces generated by the inner surface of the outer sheath 16. In some examples, the friction-reducing member 30 may be formed from a metal (e.g., Nitinol), a polymer, or a combination of metallic and polymeric materials.
Additionally, while the above discussion has focused on the ability of the friction-reducing member 30 to reduce or eliminate the friction forces generated between the outer sheath 16 and the stent 28 during deployment, it can be appreciated that the friction-reducing member 30 may also reduce or eliminate the friction forces generated between the outer sheath 16 and the stent 28 during loading of the stent 28. For example, when loading the stent 28, it can be appreciated that the stent delivery system 10 may be configured as shown in
However, as illustrated in
The materials that can be used for the various components of system 10 (and/or other systems disclosed herein) may include those commonly associated with medical devices. However, this is not intended to limit the disclosure as the discussion may be applied to other similar members and/or components of members or systems disclosed herein.
The various components of system 10 (and/or other systems disclosed herein) may be made from a metal, metal alloy, polymer (some examples of which are disclosed below), a metal-polymer composite, combinations thereof, and the like, or any other suitable material. Some examples of suitable metals and metal alloys include stainless steel, such as 304V, 304L, and 316LV stainless steel; mild steel; nickel-titanium alloy such as linear-elastic and/or super-elastic nitinol; other nickel alloys such as nickel-chromium-molybdenum alloys (e.g., UNS: N06625 such as INCONEL® 625, UNS: N06022 such as HASTELLOY® C-22®, UNS: N10276 such as HASTELLOY® C276®, other HASTELLOY® alloys, and the like), nickel-copper alloys (e.g., UNS: N04400 such as MONEL® 400, NICKELVAC® 400, NICORROS® 400, and the like), nickel-cobalt-chromium-molybdenum alloys (e.g., UNS: R30035 such as MP35-N® and the like), nickel-molybdenum alloys (e.g., UNS: N10665 such as HASTELLOY® ALLOY B2®), other nickel-chromium alloys, other nickel-molybdenum alloys, other nickel-cobalt alloys, other nickel-iron alloys, other nickel-copper alloys, other nickel-tungsten or tungsten alloys, and the like; cobalt-chromium alloys; cobalt-chromium-molybdenum alloys (e.g., UNS: R30003 such as ELGILOY®, PHYNOX®, and the like); platinum enriched stainless steel; titanium; iron, magnesium, manganese, platinum, chromium, nickel, cobalt, combinations thereof or any other suitable material.
As alluded to above, within the family of commercially available nickel-titanium or nitinol alloys, is a category designated “linear elastic” or “non-super-elastic” which, although may be similar in chemistry to conventional shape memory and super elastic varieties, may exhibit distinct and useful mechanical properties. Linear elastic and/or non-super-elastic nitinol may be distinguished from super elastic nitinol in that the linear elastic and/or non-super-elastic nitinol does not display a substantial “superelastic plateau” or “flag region” in its stress/strain curve like super elastic nitinol does. Instead, in the linear elastic and/or non-super-elastic nitinol, as recoverable strain increases, the stress continues to increase in a substantially linear, or a somewhat, but not necessarily entirely linear relationship until plastic deformation begins or at least in a relationship that is more linear that the super elastic plateau and/or flag region that may be seen with super elastic nitinol. Thus, for the purposes of this disclosure linear elastic and/or non-super-elastic nitinol may also be termed “substantially” linear elastic and/or non-super-elastic nitinol.
In some cases, linear elastic and/or non-super-elastic nitinol may also be distinguishable from super elastic nitinol in that linear elastic and/or non-super-elastic nitinol may accept up to about 2-5% strain while remaining substantially elastic (e.g., before plastically deforming) whereas super elastic nitinol may accept up to about 8% strain before plastically deforming. Both of these materials can be distinguished from other linear elastic materials such as stainless steel (that can also can be distinguished based on its composition), which may accept only about 0.2-0.44% strain before plastically deforming.
In some embodiments, the linear elastic and/or non-super-elastic nickel-titanium alloy is an alloy that does not show any martensite/austenite phase changes that are detectable by DSC and DMTA analysis over a large temperature range. For example, in some embodiments, there may be no martensite/austenite phase changes detectable by DSC and DMTA analysis in the range of about -60° C. to about 120° C. in the linear elastic and/or non-super-elastic nickel-titanium alloy. The mechanical bending properties of such material may therefore be generally inert to the effect of temperature over this very broad range of temperature. In some embodiments, the mechanical bending properties of the linear elastic and/or non-super-elastic nickel-titanium alloy at ambient or room temperature are substantially the same as the mechanical properties at body temperature, for example, in that they do not display a super-elastic plateau and/or flag region. In other words, across a broad temperature range, the linear elastic and/or non-super-elastic nickel-titanium alloy maintains its linear elastic and/or non-super-elastic characteristics and/or properties and has essentially no yield point.
In some embodiments, the linear elastic and/or non-super-elastic nickel-titanium alloy may be in the range of about 50 to about 60 weight percent nickel, with the remainder being essentially titanium. In some embodiments, the composition is in the range of about 54 to about 57 weight percent nickel. One example of a suitable nickel-titanium alloy is FHP-NT alloy commercially available from Furukawa Techno Material Co. of Kanagawa, Japan. Some examples of nickel titanium alloys are disclosed in U.S. Patent Nos. 5,238,004 and 6,508,803, which are incorporated herein by reference. Other suitable materials may include ULTANIUM™ (available from Neo-Metrics) and GUM METAL™ (available from Toyota). In some other embodiments, a superelastic alloy, for example a superelastic nitinol can be used to achieve desired properties.
In at least some embodiments, various components of system 10 (and/or other systems disclosed herein) may also be doped with, made of, or otherwise include a radiopaque material including those listed herein or other suitable radiopaque materials.
In some embodiments, a degree of MRI compatibility is imparted into the various components of system 10 (and/or other systems disclosed herein). For example, to enhance compatibility with Magnetic Resonance Imaging (MRI) machines, it may be desirable to make the various components of system 10 (and/or other systems disclosed herein), in a manner that would impart a degree of MRI compatibility. For example, the various components of system 10 (and/or other systems disclosed herein), or portions thereof, may be made of a material that does not substantially distort the image and create substantial artifacts (artifacts are gaps in the image). Certain ferromagnetic materials, for example, may not be suitable because they may create artifacts in an MRI image. The various components of system 10 (and/or other systems disclosed herein), or portions thereof, may also be made from a material that the MRI machine can image. Some materials that exhibit these characteristics include, for example, tungsten, cobalt-chromium-molybdenum alloys (e.g., UNS: R30003 such as ELGILOY®, PHYNOX®, and the like), nickel-cobalt-chromium-molybdenum alloys (e.g., UNS: R30035 such as MP35-N® and the like), nitinol, and the like, and others.
Some examples of suitable polymers that may be used to form various components of system 10 (and/or other systems disclosed herein) may include polytetrafluoroethylene (PTFE), ethylene tetrafluoroethylene (ETFE), fluorinated ethylene propylene (FEP), polyoxymethylene (POM, for example, DELRIN® available from DuPont), polyether block ester, polyurethane (for example, Polyurethane 85A), polypropylene (PP), polyvinylchloride (PVC), polyether-ester (for example, ARNITEL® available from DSM Engineering Plastics), ether or ester based copolymers (for example, butylene/poly(alkylene ether) phthalate and/or other polyester elastomers such as HYTREL® available from DuPont), polyamide (for example, DURETHAN® available from Bayer or CRISTAMID® available from Elf Atochem), elastomeric polyamides, block polyamide/ethers, polyether block amide (PEBA, for example available under the trade name PEBAX®), ethylene vinyl acetate copolymers (EVA), silicones, polyethylene (PE), Marlex high-density polyethylene, Marlex low-density polyethylene, linear low density polyethylene (for example REXELL®), polyester, polybutylene terephthalate (PBT), polyethylene terephthalate (PET), polytrimethylene terephthalate, polyethylene naphthalate (PEN), polyetheretherketone (PEEK), polyimide (PI), polyetherimide (PEI), polyphenylene sulfide (PPS), polyphenylene oxide (PPO), poly paraphenylene terephthalamide (for example, KEVLAR®), polysulfone, nylon, nylon-12 (such as GRILAMID® available from EMS American Grilon), perfluoro(propyl vinyl ether) (PFA), ethylene vinyl alcohol, polyolefin, polystyrene, epoxy, polyvinylidene chloride (PVdC), poly(styrene-b-isobutylene-b-styrene) (for example, SIBS and/or SIBS 50A), poly-L-lactic acid (PLLA), poly-D-lactic acid (PDLA), poly-lactic acid (PLA), poly(lactic-co-glycolic acid) (PLGA), poly(ε-caprolactone) (PCL), desaminotyrosine polycarbonate and the like, polycarbonates, ionomers, biocompatible polymers, other suitable materials, or mixtures, combinations, copolymers thereof, polymer/metal composites, and the like. In some embodiments the sheath can be blended with a liquid crystal polymer (LCP). For example, the mixture can contain up to about 6% LCP.
In some embodiments, the various components of system 10 (and/or other systems disclosed herein) may include a coating, for example a lubricious, a hydrophilic, a protective, or other type of coating. Hydrophobic coatings such as fluoropolymers provide a dry lubricity which improves device handling and exchanges. Lubricious coatings improve steerability and improve lesion crossing capability. Suitable lubricious polymers may include silicone and the like, polymers such as high-density polyethylene (HDPE), polytetrafluoroethylene (PTFE), polyarylene oxides, polyvinylpyrolidones, polyvinylalcohols, hydroxy alkyl cellulosics, algins, saccharides, caprolactones, and the like, and mixtures and combinations thereof. Hydrophilic polymers may be blended among themselves or with formulated amounts of water insoluble compounds (including some polymers) to yield coatings with suitable lubricity, bonding, and solubility. Some other examples of such coatings and materials and methods used to create such coatings can be found in U.S. Pat. Nos. 6,139,510 and 5,772,609, the entire disclosures of which are incorporated herein by reference.
In at least some examples, the various components of system 10 disclosed herein may include a metal stent, a bioabsorbable metal stent, a drug coated metal stent, a drug coated bioabsorbable metal stent, a polymeric stent, a bioabsorbable polymeric stent, a drug coated polymeric stent, a drug coated bioabsorbable polymeric stent, or the like. Some examples of suitable drugs and/or therapeutic agents that may be used with the medical device contemplated herein may include paclitaxel and/or derivatives thereof, everolimus and/or derivatives thereof (e.g., the “limus” family of drugs), combinations thereof, and the like, or other suitable materials.
It should be understood that this disclosure is, in many respects, only illustrative. Changes may be made in details, particularly in matters of shape, size, and arrangement of steps without exceeding the scope of the disclosure. The disclosure’s scope is, of course, defined in the language in which the appended claims are expressed.
Claims
1. A stent delivery system, comprising:
- an outer shaft having a distal end, a proximal end, and an inner surface defining a lumen extending therein;
- an inner shaft extending at least partially within the lumen of the outer shaft, the inner shaft having a stent receiving region disposed adjacent a distal end region thereof;
- a stent disposed along the stent receiving region; and
- a friction-reducing member positioned between an outer surface of the stent and the inner surface of the outer shaft, the friction-reducing member having a proximal end attached to the inner member proximal of the stent and a distal end coupled to the outer shaft distal of the stent, wherein when the outer shaft is withdrawn proximally, a single layer of the friction-reducing member forms a longitudinally collapsed and radially expanded region in which an outer diameter of the single layer increases and a length of the single layer reduces as the outer shaft moves proximally;
- wherein the outer shaft defines an outermost wall of the stent delivery system extending from a handle coupled to the proximal end of the outer shaft to distal of the stent when in a delivery configuration.
2. The stent delivery system of claim 1, wherein the longitudinally collapsed and radially expanded region is formed proximal of the distal end of the friction-reducing member.
3. The stent delivery system of claim 1, wherein as the outer shaft is moved proximally, the distal end of the friction-reducing member forms a rolled-back region, wherein the longitudinally collapsed and radially expanded region is formed proximal of the rolled-back region.
4. The stent delivery system of claim 1, wherein the friction-reducing member is configured to space the inner surface of the outer shaft radially away from the outer surface of the stent.
5. The stent delivery system of claim 1, wherein the friction-reducing member exerts a radially compressive force along the stent.
6. The stent delivery system of claim 1, wherein retraction of the outer shaft uncovers at least a portion of the friction-reducing member, and wherein the uncovered portion of the friction-reducing member expands radially outward as the outer shaft is retracted.
7. The stent delivery system of claim 6, wherein the uncovered portion of the friction-reducing member includes a flared region tapering outward to a larger diameter in a distal direction.
8. The stent delivery system of claim 7, wherein the larger diameter is greater than an outer diameter of the outer shaft.
9. The stent delivery system of claim 1, wherein the friction-reducing member is braided.
10. The stent delivery system of claim 1, further comprising a plurality of tether members each having a first end directly coupled to the friction-reducing member and a second end directly coupled to the outer shaft.
11. The stent delivery system of claim 10, wherein retraction of the outer shaft retracts the plurality of tether members in a proximal direction, and wherein retraction of the tether members folds the friction-reducing member back on itself.
12. A stent delivery system, comprising:
- an outer shaft having a distal end, a proximal end, and an inner surface defining a lumen extending from the distal end to the proximal end;
- an inner shaft extending at least partially within the lumen of the outer shaft, the inner shaft having a stent receiving region disposed along a distal end region thereof, wherein the inner shaft is designed to translate longitudinally relative to the outer shaft;
- a self-expanding stent disposed along the stent receiving region;
- a friction-reducing sleeve positioned between an outer surface of the stent and the inner surface of the outer shaft, the friction-reducing sleeve having a proximal end attached to the inner member proximal of the stent and a distal end coupled to the outer shaft distal of the stent, wherein as the outer shaft is moved proximally, the distal end of the friction-reducing sleeve forms a rolled-back region, wherein the friction-reducing sleeve forms a longitudinally collapsed and radially expanded region in which an outer diameter increases and a length reduces as the outer shaft moves proximally, wherein the longitudinally collapsed and radially expanded region is formed proximal of the rolled-back region; and
- one or more tether members coupled to the friction-reducing sleeve and extending therefrom, wherein longitudinal retraction of the outer shaft relative to the inner shaft exposes the stent from the friction-reducing sleeve.
13. The stent delivery system of claim 12, wherein retraction of the outer shaft uncovers at least a portion of the friction-reducing sleeve, and wherein the uncovered portion of the friction-reducing sleeve expands radially outward as the outer shaft is retracted.
14. The stent delivery system of claim 13, wherein the uncovered portion of the friction-reducing sleeve includes a flared region tapering outward to a larger diameter in a distal direction.
15. The stent delivery system of claim 14, wherein the larger diameter is greater than an outer diameter of the outer shaft.
16. The stent delivery system of claim 12, wherein the friction-reducing sleeve is braided.
17. The stent delivery system of claim 12, wherein the outer shaft defines an outermost wall of the stent delivery system extending from a handle coupled to the proximal end of the outer shaft to distal of the stent when in a delivery configuration.
18. A stent delivery system, comprising:
- an outer shaft having a distal end, a proximal end, and an inner surface defining a lumen extending therein;
- an inner shaft extending at least partially within the lumen of the outer shaft, the inner shaft having a stent receiving region disposed adjacent a distal end region thereof;
- a stent disposed along the stent receiving region; and
- a friction-reducing member positioned between an outer surface of the stent and the inner surface of the outer shaft, the friction-reducing member having a proximal end attached to the inner member proximal of the stent and a distal end coupled to the outer shaft distal of the stent, wherein proximal retraction of the outer shaft uncovers at least a portion of the friction-reducing member, and the uncovered portion of the friction-reducing member forms a radially outward expanded portion as the outer shaft is retracted, wherein an outer diameter of the radially outward expanded portion of the friction-reducing member is greater than an outer diameter of the outer shaft;
- wherein the outer shaft defines an outermost wall of the stent delivery system extending from a handle coupled to the proximal end of the outer shaft to distal of the stent when in a delivery configuration.
19. The stent delivery system of claim 18, wherein as the outer shaft is retracted proximally, the distal end of the friction-reducing member forms a rolled-back region, wherein the friction-reducing member forms a longitudinally collapsed and radially expanded region in which an outer diameter increases and a length reduces as the outer shaft moves proximally, wherein the longitudinally collapsed and radially expanded region is formed proximal of the rolled-back region.
20. The stent delivery system of claim 12, wherein the friction-reducing sleeve is braided.
Type: Application
Filed: May 22, 2023
Publication Date: Sep 28, 2023
Applicant: BOSTON SCIENTIFIC SCIMED, INC. (Maple Grove, MN)
Inventors: Gary Gilmartin (Foxford), Geraldine Toner (Raphoe)
Application Number: 18/321,441